Saturday, January 20, 2018

Prohibition the real cause of the 'opioid crisis'

January 18, 2018 - "For nearly a decade, policymakers have bought into the misguided narrative that the opioid overdose crisis is a result of careless doctors and greedy pharmaceutical companies getting patients hooked on prescription opioids and condemning them to the nightmarish world of drug addiction. As a result, the Drug Enforcement Administration has ordered decreases in prescription opioid production. There was a 25 percent reduction in 2017 and a 20 percent reduction is ordered for 2018.

"States have set up monitoring programs that put doctors and patients under surveillance leading to a dramatic reduction in the prescription of opioids since 2010. In fact, high-dose prescribing fell 41 percent since 2010.... This focus on the supply and prescription of opioids makes many patients needlessly suffer in pain. Some, in desperation, turn to the illicit market to get relief, where they find heroin and heroin-laced fentanyl often cheaper and easier to get. Some others resort to suicide.

"Policymakers mistakenly focus on doctors treating their patients in pain. By intruding on the patient-doctor relationship, they impede physician judgment and increase patient suffering. But another unintended consequence is that, by reducing the amount of prescription opioids that can be diverted to the illicit market, they have driven nonmedical users to heroin and fentanyl, which are cheaper and easier to obtain on the street than prescription opioids, and much more dangerous....

"The overdose rate is not a product of doctors and patients abusing prescription opioids. It is a product of nonmedical users accessing the illicit market.

"The problem will not get better — it will probably only get worse — as long as we continue to call this an 'opioid crisis.' The title is too nonspecific. This is a crisis caused by drug prohibition, an unintended consequence of nonmedical drug users accessing the black market in drugs.

"Policymakers should stop harassing doctors and their patients and shift their focus to reforming overall drug policy. A good place to start would be to implement harm reduction measures, such as safe syringe programs, making Medication Assisted Treatments like methadone and suboxone more readily available, and making the opioid antidote naloxone available over-the-counter, so it can be easier for opioid users to obtain. Even better would be a sober reassessment of America’s longest war, the 'War on Drugs.'"